Prerequisites: Successful completion of Year 2
Additional Requirements:Inpatient pediatric experience is preferred but not required. C form and letter of intent to Candice Russell at crrussell@seton.org

Responsible Faculty Director:Valli Annamalai, M.D.Other Faculty:

Location to Report on First DayCandice Russell at crrussell@seton.org or 512-324-7860

Periods Offered1-12 including Period 12 (June), NOT including the holiday vacation Period 13 (Dec)

Maximum Enrollment2

Goals

The student will develop skills in the care of hospitalized children and will learn an approach to the management of complex illnesses. The key concept to this elective is that the student will be facing many of the same challenges as an intern.

Objectives

At the completion of this course the student should:
1. Feel comfortable obtaining a complete history and a physical examination on a pediatric patient.
2. Formulate a problem list and a pertinent differential diagnosis and develop a therapeutic plan for common pediatric problems.
3. Establish priorities in formulating plans.
4. Identify rationale for diagnoses and plans.
5. Utilize appropriately a consultantís opinion.
6. Be able to admit and enter orders on new patients.
7. Be comfortable with patient presentations during family-centered rounds.

Description of course
activities

The student will have the opportunity to function as a pediatric intern on the inpatient service at Dell Childrenís Medical Center of Central Texas. He/she will be assigned to a team consisting of an attending, a senior resident, two junior residents, and third year medical students. The student will be assigned patients for whose care he/she will be responsible. The student will round with their inpatient team daily and attend morning reports and noon conferences. The student will have the opportunity to interact with the attendings, subspecialists, and other members of the healthcare team.

Type of students who would
benefit from the course

Students interested in a residency in Pediatrics or Family Medicine, or other fields that involve caring for children. To enroll, UTMB students should submit a C-form and a letter of intent to Candice Russell at crrussell@seton.org for approval. Visiting students should submit an application through VSAS: https://services.aamc.org/20/vsas/public/school/instID/174 Select UTMB at Galveston as the host institution and indicate you wish to take PEDU 4034 on the application as well as a letter of intent outlining you interest in pediatrics, why the Austin program and inpatient experience.

What expectations do you have for the
student to demonstrate participation in the elective (e.g. small group
activities, seminars, thoughtful questions, providing resources, journal
club, resident lecture attendance)?

The student is expected to take ownership of his/her patients, including presenting to the families, communicating with nurses and other staff, and following up on patient care tasks. The student will also be asked to write or type a discharge summary on their patients so that the senior resident may use this for their dictations.

6. Other Modes of Evaluation

Please explain below.

Students will be evaluated by the Pediatric Attending Physician using the student's offical school evaluation form.

7. If this course is an Acting
Internship, please
complete the following:

A.

Specify how the student will be given formative feedback on their clinical skills.

At a minimum, biweekly face to face formative feedback will be provided to the student by their attending and/or senior resident.

B.

List advanced clinical skills that a student will be assured an opportunity to practice.

The student will lead the discussion of their patients on rounds, including educating the family by providing anticipatory guidance, and educating the team on their readings. The student will take on primary responsibility for their patients; focus histories, physicals, and oral and written communication appropriately; share information effectively with patients and families; prioritize and organize work effectively; anticipate what a patient will need during the course of the hospitalization and communicate this information in handoffs; continuously re-evaluate patients to notice a change in status and communicate this to their supervisors; cope with uncertainty in patient care issues; recognize when to ask for help; function as a team player with residents, attendings, nurses, and ancillary staff; coordinate the care of patients during hospitalization and in discharge planning.

C.

List other advanced clinical skills that a student may be exposed to depending on clinical case availability.

The student may be able to participate in a care conference on a patient with medical complexity, transfer a patient to a higher level of care such as the ICU, or consult a subspecialist for recommendations.

D.

How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?

Similar: having primary responsibility for patient care and education of family; taking focused history and physical examinations; handoff their own patients in the evenings, and receive handoffs in the mornings.
Differences: Currently, unable to enter notes in the EHR (but this will be changing soon); dictating discharge summaries (will be written or typed instead); entering prescriptions

E.

How will this course help prepare a student enter an internship in this field or a related field?

Inpatient pediatrics is a major component of pediatrics residency training. Having practice in the role of the intern, from start to finish of a patient's hospitalization, with a similar work schedule, similar responsbilities, and earning more autonomy, will help prepare the student for the rigorous workday an intern experiences.

F.

How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Midpoint feedback will be provided with a face to face discussion with the faculty. Deficiencies identified at midpoint will be addressed along with an action plan after discussion. Faculty and senior resident will provide guidance on how improvements can be made.

G.

Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.

Typically, there are 2 primary faculty who will be the supervisors for the team during the day. On nights, the student will work with various other faculty, but this will not be consistent as the daytime attendings. The student will work with 1 faculty member for 10 days, and the other for 5 days. Direct supervision is provided by the senior resident and by faculty on rounds and with faculty and senior residents on call on the week of nights.